HomeMy WebLinkAboutPermit Mechanical 1999-3-24
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
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LOCATION OF PROPOSED WORK:
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-<'LOT'
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BLOCK:
OWNER:~~'i!'9</) /1tfldo. AJP_
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JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
'1 '7 '1'7 /
023&-0
TAX LOl:
SUBDIVISION'
PHONE:.1i..h-/ - 3 ( s: '-I
ZIP: _Cf '7 '-I 0 L
DESCRIBE WORK: r 6 AJ \/~ RTF iRe r;> L /I C ~ T-;:., '5 a. S
NEW REMODEL ADDITION DEMOLISH OTHER
L D9 S'
K v
CONTRACTOR'S ~) ~ Ley s /b~ls tV ('lIl CON ST.
ADORE S CONTRACTOR # EXPIRES '.~ PHONE
GENERAl' 1 e!Jf!1l) t e-'I S -I7-lA .3<(..1 ~1/3!
~ oR
PLUMBING' c IA c;.z AJ Q..
'/ MECHANICA' .
ELECTRICAl'
- OFFICE USE -
QUAD AREA' LAND USE:_ FLOOD PLAIN'
# OF BLDGS' # OF UNITS' ZONING CODE:
OCCY GROUP' CONSTR. TYPE: # OF BDRMS'
# OF STORIES' HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGF' SQUARE FOOTAGE:
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. All Inspections requested before 7:00 a.m. will be
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
o Temporary ElectrIc
O Site Inspection - To be medo
after excavation. but prior to
settlng forms.
o Underslab Plumblng/Electrlcall
Mechanlcel - Prior to cover.
o Footing - After trenches are
excavated. .
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected. but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
O Underlloor Plumblng/Mechenlcal
- Prior to Insulation or decking.
o Post and 8eam - Prior to floor
Insulation or decking.
o Floor Insulallon - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
O Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough ElectrIcal - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms Bre erected but prior to
placement of concrete.
o Sidewalk & Drlvew3V - After
excavation Is complete, forms
and sub.base material In place.
D Fence - When completed.
o Street Trees - When all required
trees are planted.
o Final Plumbing - When all
plumbing work Is complete.
. .
D Final Electrical - When all
electrical work Is complete.
'1V1 Final Mechanical - When all
~echanlcal work Is complete.
o Final BUilding - When all
required Inspections have been
approved and building Is
completed.
1Z]'0ther /f- UA..>c
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home Is con nee led to
the service panel.
o Final - After all required
Inspections are approved and
porchos, sklrtlng, decks, and
venting have been Installed.
Lot faces
Lot ~ype .
Lot sq. ftg.
Interior
Lot coverage
Corner
Topography
Panhandle
Total height
Cul.de.sac
BUILDING PERMIT;
ITEM SO. FT.
't
X $/SO. FT, =
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fec
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
FT.
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/ Fireplace Unit
Dryer Vent
MZh!/ ,C~ / AZ
Mechanical Permit
Issuance
Stale Surcharge I 7 r +- (f)-
Total Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DiJE (excluding electrical)
(A, B, C, D, and E Combined)
Setbacks
HSE GAR
I P.L.
IN
Is
W -t
E
VALUE
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FEE
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,
/ C) ;n'
/2..0
2b.2-'6
/-;;/. 2-0
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I(.THE PROPOSED WORK IN THE'.
"'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER'?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
" "i:i ":
ACC I
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" ",. . '.
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
APPROVEP'
This permit Is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City ,of Springfield, Including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
2.
Date Paid:
Recel pt Number'
Received By:
Plans RevIewed By
Date
Systems Development Charge Is due on all undeveloped
properlles within the City limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby 'certify that all
Information hereon Is true and correct, and I further certify
that any and all work performed shall be done In accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I further agree to ensure that all required Inspections arc
requested at the proper time, that each address I~ readabie
from the street, that the permit card Is located at the front
of the property, and the approved set of plans wilt remain
~ on the site at all times during construction. /
Slgnature./}~ --r>R f/ '74d<2-.-,_
--'
Date 3/02 slY 9
VALIDATION:
RECEIPT NUMBER
03'3?7(
5/24;9/'
-:1 /:. 2 0
.'~
DATE PAID
AMOUNT RECEIVEt"
RECEIVED BY _